Sarit A Golub, Stephanie Hubbard, Ariel M de Roche, Staci C Barton, Angela Merges, Augustus Klein
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Project Partnership to Increase Access, Client-Centered Care, and Equity in HIV Services is a community-academic implementation science partnership designed to investigate the impact of strategy enactment on implementation outcomes, including changes in intervention utilization (HIV testing, sexually transmitted infection testing, pre-exposure prophylaxis) in practice over time. This article presents preliminary implementation outcomes collected from the 19 programs (client <i>N</i> = 8,865) funded to adopt GOALS. Data indicate the successful enactment of systems-level strategies (infrastructure development, service mandates), program-level strategies (staff training, learning collaboratives), and provider-level strategies (utilization of the GOALS). By Quarter 5, the GOALS was being utilized in a median of 84% of visits across programs (interquartile range: 54%-97%), and GOALS utilization was positively associated with provider adoption of HIV prevention interventions in practice. Programs that struggled with implementation had less buy-in from leadership and lower commitment to provider training; programs with upward implementation trends had less experience delivering sexual health care and used a phased approach to foster support, focusing on the positive reaction to the GOALS among their clients. These data suggest that a multilevel implementation strategy focused on delivery of antistigma, client-centered sexual histories may be a potent implementation strategy for enhancing HIV prevention intervention adoption. 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These data suggest that a multilevel implementation strategy focused on delivery of antistigma, client-centered sexual histories may be a potent implementation strategy for enhancing HIV prevention intervention adoption. 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引用次数: 0
摘要
由于有效的生物医学干预措施(例如艾滋病毒检测、接触前预防)的利用不够理想,特别是对发病率最高的人群而言,制止艾滋病毒流行的进展缓慢。2021年,纽约市卫生局启动了一项多层次实施战略,重点是推广“性史与健康目标方针”——一项反污名化、以客户为中心的性史获取战略——作为提高艾滋病毒干预措施采用、覆盖范围和公平性的杠杆。增加艾滋病毒服务的可及性、以客户为中心的护理和公平性项目伙伴关系是一个社区学术实施科学伙伴关系,旨在调查战略制定对实施结果的影响,包括长期以来干预措施利用(艾滋病毒检测、性传播感染检测、暴露前预防)的变化。本文介绍了从19个项目(客户N = 8,865)中收集的初步实施结果。数据表明成功制定了系统级战略(基础设施开发、服务要求)、项目级战略(员工培训、学习协作)和提供者级战略(目标的利用)。到第5季度,目标的使用率中位数为84%(四分位数范围:54%-97%),目标的使用率与提供者在实践中采用艾滋病毒预防干预措施呈正相关。在实施过程中遇到困难的项目,领导层的支持较少,对提供者培训的承诺也较低;实施呈上升趋势的项目在提供性健康保健方面的经验较少,并且采用分阶段的方法来促进支持,重点关注其客户对千年发展目标的积极反应。这些数据表明,侧重于提供反污名化、以客户为中心的性史的多层次实施策略可能是一种有效的实施策略,可促进艾滋病毒预防干预措施的采用。(PsycInfo Database Record (c) 2025 APA,版权所有)。
Community-academic implementation science partnership to examine adoption and impact of a patient-centered approach to sexual history.
Progress toward ending the HIV epidemic has been slowed by suboptimal utilization of effective biomedical interventions (e.g., HIV testing, pre-exposure prophylaxis), especially for populations with the highest incidence. In 2021, the New York City Health Department initiated a multilevel implementation strategy, focused on promoting the GOALS Approach to Sexual History and Health-an antistigmatizing, client-centered strategy for sexual history taking-as a lever for increasing HIV intervention adoption, reach, and equity. Project Partnership to Increase Access, Client-Centered Care, and Equity in HIV Services is a community-academic implementation science partnership designed to investigate the impact of strategy enactment on implementation outcomes, including changes in intervention utilization (HIV testing, sexually transmitted infection testing, pre-exposure prophylaxis) in practice over time. This article presents preliminary implementation outcomes collected from the 19 programs (client N = 8,865) funded to adopt GOALS. Data indicate the successful enactment of systems-level strategies (infrastructure development, service mandates), program-level strategies (staff training, learning collaboratives), and provider-level strategies (utilization of the GOALS). By Quarter 5, the GOALS was being utilized in a median of 84% of visits across programs (interquartile range: 54%-97%), and GOALS utilization was positively associated with provider adoption of HIV prevention interventions in practice. Programs that struggled with implementation had less buy-in from leadership and lower commitment to provider training; programs with upward implementation trends had less experience delivering sexual health care and used a phased approach to foster support, focusing on the positive reaction to the GOALS among their clients. These data suggest that a multilevel implementation strategy focused on delivery of antistigma, client-centered sexual histories may be a potent implementation strategy for enhancing HIV prevention intervention adoption. (PsycInfo Database Record (c) 2025 APA, all rights reserved).
期刊介绍:
Psychological Services publishes high-quality data-based articles on the broad range of psychological services. While the Division"s focus is on psychologists in "public service," usually defined as being employed by a governmental agency, Psychological Services covers the full range of psychological services provided in any service delivery setting. Psychological Services encourages submission of papers that focus on broad issues related to psychotherapy outcomes, evaluations of psychological service programs and systems, and public policy analyses.